How to Explain past Board Orders to Employers

If a nurse receives an Agreed Order from the Texas Board of Nursing it is a disciplinary action and will forever be on the nurse's license (unless some future legislation allows for this to be changed). Even though the nurse has completed the probation/restrictions/stipulations and the nurse's license is now active and clear, the nurse will have a disciplinary history. This means that if the nurse is applying for a job and on the application is a question - "Has your license ever been sanctioned, disciplined, revoked, suspended or otherwise had action taken against it?"(or some similar type of question), the nurse will have to answer "yes."

The nurse should keep a copy of the Order and of the letter from the Board indicating that the Order has been completed and be prepared to present this to the employer.

New Continuing Education Hours

Do you have a nursing license and are not currently working as a nurse? If so, you should read the Texas Board's proposed CUE rules because they will affect you. Go to the Board's website and click on the May 15, 2009 proposed rules for Chapter 216. The new rules require nurses to demonstrate continuing competency in the nurse's specific area of practice. The problem is that if you are not working as a nurse, you do not have an "area of practice."

Every nurse that this impacts needs to immediately read the rules and send a comment to the Board detailing how they would be impacted by the new rules. According to the Board "To be considered, written comments on the proposal or any request for a public hearing must be submitted no later than 5:00 p.m. on June 14, 2009, to James W. Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to dusty.johnston@bon.state.tx.us, or faxed to (512) 305-8101. An additional copy of the comments on the proposal or any request for a public hearing must be simultaneously submitted to Denise Benbow, Nursing Practice Consultant, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to denise.benbow@bon.state.tx.us, or faxed to (512) 305-8101. If a hearing is held, written and oral comments presented at the hearing will be considered.

New laws and rules (TPAPN, Substance Abuse, Psychiatric Examinations, Minor violations)

HB 3961 has been sent to the Governor for his signature, which will most likely occur. Every nurse needs to be familiar with this bill because of its impact on nursing practice. Especially if a nurse has or accused of having a substance abuse problem or a mental health issue or a physical impairment. The Legislature has granted many more regulator powers to the Board including immediate suspension of a nurse's license for violations of conditions of a Board Order.

IT IS CRITICAL that a nurse seek the advice of an experience administrative attorney prior to entering into an Order with the Board for a substance abuse problem or a mental health issue or a physical impairment. The best approach is to contact an attorney as soon as something arises so that the attorney can prepare your case and start your defense.

Unfortunately, HB 998 stalled in the House and so the procedure still allows the Boards to change an Administrative Law Judge's decision after a hearing.

A bright light is that SB 1415 has been signed into law. The first section of the law instructs the Board to set up a pilot program to evaluate a deferral of disciplinary action when a nurse has been a violation that does not rise to the level of a denial, suspension or revocation. The second section is even more interesting: the Board is instructed to adopt guidelines for violations types that can have a "corrective action" imposed. This corrective action would be a fine, remedial education or both. I see lots of cases where this could apply and it is going to be very important that a nurse get assistance from an administrative lawyer familiar with the Board in order to make sure that they do not miss out on the potential resolution. The bill takes effect on 9/1/09.

Bill to defer BON disciplinary actions

According to the analysis of SB1415, "The 80th Legislature, Regular Session, 2007, passed S.B. 993, authored by Senator Nelson and sponsored by Representative McReynolds, in order to promote a less punitive regulatory environment for nurses who have committed minor violations and to have the Texas Board of Nursing (board) focus its disciplinary efforts and resources on nurses whose continued practice poses a risk of harm to patients. This legislation is in keeping with the recommendations of the Institute of Medicine's report, To Err Is Human and Keeping Patients Safe: Transforming the Work Environment of Nurses, which concluded that patient safety is best promoted by a regulatory environment which focuses more on system issues and less on individual blame for minor infractions.

Deferred disciplinary action is a decision made by the board to defer taking final disciplinary action against a nurse, and if the nurse meets certain conditions, dismissing the complaint. This bill would build on S.B. 993 by directing the board to determine the feasibility of conducting a pilot program to evaluate a model of deferred disciplinary action for minor violations, and if determined to be feasible, to conduct such a pilot program.

C.S.S.B. 1415 amends current law relating to certain corrective actions by the Texas Board of Nursing, including a pilot program on deferred disciplinary action, and provides corrective actions."

The bill has made it over the House's Public Health Committee. The Legislature is moving quickly on several bills and we are in the last few legs of the process. I am disappointed with several bills, but others look promising. More to come once the session is over.